By Lawrence Powell
A new Collaborative Emergency Centre in Annapolis Royal is taking a page from the past to help write a chapter for the future -- and residents will still have access to health care 24/7 at the Annapolis Community Health Centre.
Doctors and administrators at a packed King's Theatre Monday evening outlined for residents of the ACHC catchment area just what they can expect when the new CEC goes live on September 17. The biggest difference will be at night when the centre will be staffed by a registered nurse, a primary care paramedic, and an LPN with an online doctor just a phone call away to consult with onsite staff if necessary.
Dr. Ken Buchholz likened the nighttime on-call doctor to the old days when physicians such as Dr. Kerr were called at home if staff at the hospital needed to consult with a doctor. Except now it will be done through Emergency Health Services.
Buchholz, who already works as an online physician for other CECs in the province, said the system is already working well elsewhere and means doctors at ACHC will be fresh the next day, able to take appointments, provide better care, keep people healthier so they won't have to come to the emergency department.
Another change at ACHC will be the absence of ambulances. Emergency calls to 911 from the public will see patients delivered to the best, nearest site available, but none will go to Annapolis Royal. Buchholz said that patients with real emergencies such as chest pain or broken bones will get faster service and more prompt care by calling 911 because a stop at ACHC would be an unneeded delay. They would be sent to Kentville from ACHC anyway.
Patients who do arrive at ACHC after 8:30 p.m. will be treated as necessary, or if their symptoms appear less urgent an appointment can be booked for the next day with the CEC daytime doctor.
Daytime service at ACHC will include the CEC doctor on duty, the xray department open from 8 a.m. to 4 p.m. seven days a week, blood collection from 8 to 9:30 a.m. five days a week, no change to inpatient beds, and same-day or next-day doctor appointments.
Dr. Simon Bonnington told the crowd that there was no choice in moving to the provincially mandated Collaborative Emergency Centre model, but ACHC did have a lot of choice in how good to make it and how to harness what they already had. He said ACHC already had 24/7 care, no doctor shortage, and a collaborative practice. He said changing to a CEC was about optimizing roles.
He defined the ACHC catchments area as a line from Hampton, through Bridgetown, to just east of Northfield, the Bay of Fundy, and Queens and Digby county lines -- with the exception of Bear River. That community will be entirely within the ACHC area.
Bonnington said five categories of patients will have access to health care at ACHC with the first being local patients with a local doctor. If their need is urgent they will be seen by a doctor at the CEC. Second is local people with a doctor outside the catchment area. They will be encouraged to make a same-day or next-day appointment at the CEC. The third are local people with no doctor. If their need is not urgent they will also be urged to make a same-day or next-day appointment. Four are patients on a local doctor's list but who live outside the catchment area. The final category includes people outside the area and not on a local doctor's list. These latter two categories of patients will be asked to sit and wait -- as they would currently.
Bonnington said local people with no doctor will be the ones who gain the most. He admitted that ACHC won’t be a fully functional emergency department, but said that doesn’t mean emergency patients will receive worse care – just care in a different place.
The priority for the CEC doctor will be the most urgent cases come first, same-day or next-day appointments come second. Third in priority are the non-booked people.
Another first at the Annapolis Royal CEC will be electronic medical records accessible by CEC staff 24 hours a day, something the doctors said will help save time searching for paper files. And this is especially import in a centre that practices a team approach to treating patients.
ACHC site manager Karen Smith said parking is being redeveloped, a reflection of increased services including the current specialist and a new monthly pediatrics clinic starting this fall. There are also two family medicine residency students on staff for the next two years (see story Page 10) and on Monday new beds arrived at the ACHC thanks to the Annapolis West Health Foundation. She also described new xray equipment worth $120,000.
But she said the bottom line is that everybody who shows up at the new CEC will receive care.
“I’m so proud I could almost burst with what’s going on at the health centre,” she said.
Annapolis Valley Health president and CEO Janet Knox said the team planning the new CEC has been working very hard to present a unique model, one she said will be a model for the rest of the province.
Need For Feedback
Both doctors and Smith urged the public to offer feedback and input as the CEC gains its legs. “We think that this is going to work very well,” said Buchholz. “We need public input to make sure this works even better.”
Wayne Boucher, interim chair of the Friends of the Annapolis Community Health Centre, urged that AVH continue an open dialogue with his organization. Bonnington agreed with the need for ongoing and better dialogue and Smith agreed with Boucher’s call for a two-way flow of information.
Stephen McNeil asked if the new CEC would mean any financial savings. EHS regional manager Jay Walker said he didn’t know but it will result in much better care. “And that’s the point,” he said. Bonnington agreed that there was no answer to McNeil’s question. He said the new CEC will mean “more care, quicker care, better care.” Smith didn’t think there would be any great financial savings – just better care.
Betty Matson, new AVH chair, said eyes will be on Annapolis Royal to see how successful the new CEC will be. “You’ll make it work,” she said. “Keep the dialogue open with Karen, Janet, and even me.”